Synergy of human neutrophils with fluconazole in killing Candida species

The killing of Candida species by human neutrophils in a long-term 24-h assay and possible synergy with fluconazole (FCZ) for killing was investigated. The test medium (TM) consisted of RPMI-1640, penicillin and streptomycin (P/S), and 10% fresh autologous serum. TM alone was highly fungistatic for Candida species compared to TM without serum. When neutrophils were cocultured in TM with Candida species for 24 h the inoculum colony-forming units (CFU) were always significantly reduced (killing) by 58 to 99%. FCZ was tested over a range of 1-500 micrograms/ml, and though almost always fungistatic itself, it synergized with neutrophils for significantly increased killing of C. albicans (isolate Sh27) (P < 0.01) and C. albicans (isolate 94-20) (P < 0.05). Killing of non-albicans Candida species was so efficient in the absence of FCZ that demonstration of synergy with FCZ was difficult.     

Chronic neutrophilic meningitis caused by Candida albicans

Meningitis caused by Candida albicans is a very infrequent entity. We present 3 intravenous drug users with chronic neutrophilic meningitis caused by Candida albicans. The clinical, microbiological and radiological features of the 3 patients are reviewed. The interval between the onset of the disease and the diagnosis was long (from 4 to 12 months). Candida albicans was cultured from cerebrospinal fluid (CSF) in the 3 patients. All of them developed hydrocephalus, meanwhile arachnoiditis was disclosed in two. The therapy with amphotericyn, 5-flucytosine and fluconazole produced clinical improvement and the sterilisation of the CSF in all the 3 cases. Clinicians should be aware of this entity because of diagnosis may be delayed in several months.     

Serum-mediated enhancement of TNF-alpha release by human monocytes stimulated with the yeast form of Candida albicans

The role of serum in the production of tumor necrosis factor-alpha (TNF-alpha) by human monocytes stimulated with yeast-form Candida albicans was studied. Pre-exposure of C. albicans to human pooled serum enhanced both TNF-alpha mRNA and cytokine secretion compared with C. albicans preincubated with medium only. Serum factors involved were >30 kDa, were efficiently inhibited by D-mannose, and recognized both Ca++-dependent and -independent pathways. Preincubation of yeasts with rabbit mannose-binding protein (MBP) resulted in dose-related enhancement of TNF-alpha secretion, through a Ca++-dependent pathway inhibited by D-mannose. TNF-alpha levels were similarly induced in C. albicans preincubated with vitronectin and with serum. Ca++ depletion did not affect cytokine release, while D-mannose supplementation displayed inhibition. The latter effect was abolished after Ca++ depletion. These data call for an involvement of both MBP and vitronectin in the serum-mediated enhancement of TNF-alpha release upon stimulation of monocytes with yeast forms of C. albicans.     

Incidence of mother-child contamination by Candida albicans during labor

Two different studies assessed that materno-fetal contamination at time of delivery is not the usual way of colonization of newborns with Candida albicans. In a first study, occurence of Candida albicans in neonate units disappeared owing to prophylactic measures, such as strict care in hospital hygiene. In a second study, detailed herein and performed in an obstetric ward, it was found that despite a rate of vaginal Candida carrier of 19 %, candidiasis in newborns was exceptional.     

Utility of Fluoroplate Candida for the rapid identification of Candida albicans

BACKGROUND: Candida albicans infections are frequent in immunocompromised patients and a prompt diagnosis could favor an early and proper antifungal treatment. The rapid identification of clinical yeast isolates facilitate this diagnosis. METHODS: The utility of Fluoroplate Candida ready-to-use plates for Candida albicans rapid identification was evaluated with 653 clinical isolates from 23 yeast species, including 307 C. albicans plated onto Fluoroplate Candida agar (Merck, Germany). Rapid identification of C. albicans was based on the hydrolysis of 4-methylumbelliferyl-N-acetyl-beta-D-galactosaminide by the galactosaminidase activity of C. albicans producing white fluorescent colonies under ultraviolet light. Identification on Fluoroplate Candida was confirmed by germ tube, chlamydoconidia formation and API-ATB ID 32C assays. RESULTS: Three hundred and five of 306 isolates showing fluorescent colonies were C. albicans and one was Candida glabrata (false positive). The rest of the isolates showed colonies without fluorescence and with the exception of two false negatives, these isolates were identified as non-C. albicans by other methods. CONCLUSIONS: Fluoroplate Candida allows a rapid and excellent identification of C. albicans showing a sensitivity and specificity of 99.3 and 99.7%, respectively.     

Secreted aspartyl proteinases and interactions of Candida albicans with human endothelial cells

The endothelial cell interactions of homozygous null mutants of Candida albicans that were deficient in secreted aspartyl proteinase 1 (Sap1), Sap2, or Sap3 were investigated. Only Sap2 was found to contribute to the ability of C. albicans to damage endothelial cells and stimulate them to express E-selectin. None of the Saps studied appears to play a role in C. albicans adherence to endothelial cells.     

The formation of hyphae of Candida albicans induced by cyclodextrins

Hyphal growth of Candida albicans was observed when yeast was cultured at 27 degrees C in liquid media containing 1% Tripcasine and 1.8% cyclodextrins (alpha, beta, and gamma respectively). Tripcasine as the sole nitrogen source did not induce the formation of hyphae of C. albicans, but cyclodextrins, especially CD-beta, were able to induce yeast-mycelial transition. In the TCD-beta media 25-30% septate hyphae form was observed. This study indicates the existence of an uptake system for CDs in C. albicans, provided these compounds are linearised in the medium. The CDs are inducers of hyphae and they may enter the C. albicans cells as linear oligosaccharids.     

Isotachophoretic analysis of short-chain carboxylic acids produced by Candida albicans

Short-chain carboxylic acids produced by Candida albicans in glucose supplemented batch cultures and in human denture plaque has been qualitatively and quantitatively analysed using isotachophoresis. This rapid, simple and relatively new technique which has advantages over other conventional methods, such as gas liquid chromatography, could be a valuable tool in the analysis of carboxylic acids produced by other yeasts of clinical and industrial importance.     

Cryptococcus neoformans and Candida albicans regulate CD4 expression on human monocytes

This study examined the capability of Candida albicans and Cryptococcus neoformans to modulate CD4 expression on human monocytes. C. albicans and an acapsular strain of C. neoformans induced higher levels of CD4 expression than encapsulated strains. Purified glucuronoxylomannan did not regulate CD4 expression on monocytes, but down-regulation of CD4 expression compared with stimulation by acapsular C. neoformans alone was observed when glucuronoxylomannan was used in combination with acapsular C. neoformans. The ability of opsonic factors to facilitate fungal-mediated CD4 overexpression suggests that binding or internalization (or both) of the yeast cells is a critical event. Protein synthesis was required, excluding redistribution of the intracellular pool of CD4 receptors to the cellular surface as the sole possible mechanism. Results demonstrate a new effect of fungi on professional phagocytic cells and raise the possibility that modulation of CD4 could influence gp120-mediated human immunodeficiency virus entry.     

Antifungal susceptibility of clinically isolated Candida albicans by broth microdilution method

In this study we investigated the antifungal susceptibility of 285 strains of Candida albicans isolates at Kinki University Hospital from March 1995 to December 1996. The antifungal agents tested were fluconazole, miconazole, intraconazole, amphotericin B and flucytosine. The susceptibility testing were performed according to the broth microdilution method standardized by National Committee for Clinical Laboratory Standards (M27-T). Most isolates of C. albicans showed relatively a low MIC value and the MIC90S were calculated at 1 microgram/ml; fluconazole, 0.125 microgram/mg; miconazole, 0.06 microgram/ml; itraconazole, 1 microgram/ml; amphotericin B, 0.25 microgram/ml; flucytosine. There was only one strain that showed high resistance against fluconazole and it showed cross-resistance against miconazole and itraconazole. There were two flucytosine resistant strains. The MICs of amphotericin B were tightly clustered and resistant strain were not observed.     

Fungicidal effect of tyrothricin on Candida albicans

Tyrothricin, a polypeptide antibiotic, is active against yeast cells. Tyrothricin was rapidly fungicidal towards Candida albicans. Concentration of four times the minimum inhibitory (25 mg l-1) reduced the yeast numbers by more than 3 log10 within 1 h. Similar results were obtained in a flow cytometric antifungal activity assay using the new two-colour probe for yeast viability, FUN-1, which measures impairment of metabolic activity. The respiratory activity of Candida albicans, measured in a XTT kinetic assay, was significantly reduced in comparison with controls by 3.12 mg l-1 of the substance. Because fungicidal concentrations of tyrothricin are locally achievable in patients, an evaluation of the local effect of tyrothricin in patients suffering from mucosal infections with Candida species should be considered.     

Standardized molecular typing of Candida albicans strains

A method is presented for the standardization of Candida albicans DNA fingerprinting, which is based on Southern hybridization of EcoRI-digested chromosomal DNA with the moderately repetitive DNA element CARE-2 and the subsequent rehybridization of the blots with a molecular size marker also included in each DNA sample. This method resulted in extremely precise alignment of all strain-specific CARE-2 hybridization patterns, even when analysed on different gels, and will enhance the accuracy of genetic relationship determinations in epidemiological studies including large numbers of strains.     

Interleukin-15 augments superoxide production and microbicidal activity of human monocytes against Candida albicans

Overexpression of EGFR and c-erbB2 frequently occurs in human breast cancers, correlating with poor prognosis. Here we show that overexpression of EGFR and c-erbB2 in cell lines increases cell migration, an important step in metastasis formation. The effect of EGFR on migration is dependent on the addition of EGF to the cells. In contrast, c-erbB2 seems to act independently of its ligand in these assays. Overexpression of this receptor is sufficient to induce cell migration. In addition, we investigated the involvement of a number of signal transduction pathways known to be activated by the EGFR. We found that inactivation of MAPKK results in a decreased migration, while inactivation of PI3K increases migration.     

Endothelial cell injury caused by Candida albicans is dependent on iron

MRL-lpr/lpr mice spontaneously develop manifestations of autoimmunity including arthritis, vasculitis, and glomerulonephritis. The paramagnetic molecule nitric oxide has been implicated as an effector molecule in initiation and propagation of these inflammatory conditions. In this study, we utilized electron paramagnetic resonance spectroscopy to directly detect nitrosylated protein complexes as products of nitric oxide in whole blood and in kidneys of MRL-lpr/lpr mice. Electron paramagnetic resonance spectra of blood samples from MRL-lpr/lpr mice showed nitrosyl hemoglobin species. Amounts of blood nitrosyl hemoglobin in MRL-lpr/lpr mice were significantly increased as compared to age-matched control mice. Electron paramagnetic resonance spectra of MRL-lpr/lpr kidney tissue exhibited a signal characteristic of a dinitrosyl-iron-dithiolate complex at g approximately 2.04. Formation of nitrosylated nonheme protein in diseased kidneys is associated with development of glomerulonephritis in the autoimmune mice. The presence of nitrosylated nonheme protein indicates the formation of nitric oxide within the kidneys of the diseased mice signifying in situ renal nitric oxide formation.     

Control of Candida albicans murine vaginitis by topical administration of polycarbophil-econazole complex

The complexation of econazole with the mucoadhesive polycarbophil was found to significantly improve the therapeutic benefit of the drug in the topical treatment of experimental vaginal candidiasis in mice, while no difference in the antimycotic activity exerted by econazole and polycarbophil-econazole could be detected in vitro.     

The effects of antifungal agents on the morphogenetic transformation by Candida albicans in vitro

There are currently three mood stabilizers available for the maintenance treatment of patients with bipolar I disorder: lithium, valproate, and carbamazepine. Unfortunately, monotherapy with each of these conventional agents often fails. To improve outcome, clinicians utilize polypharmacy. Although the efficacy of this practice is largely unknown, because of the lack of controlled studies, data from the United States and Europe indicate polypharmacy is the rule rather than the exception. The few controlled trials that have been conducted indicate that (1) the specific combination of lithium plus imipramine provides no advantage over lithium monotherapy (notwithstanding the inadequacy of lithium monotherapy); (2) the specific combination of lithium and the depot neuroleptic flupenthixol provides no advantage over lithium monotherapy; and (3) the combination of lithium plus carbamazepine may be as effective as lithium plus haloperidol for acute and continuation treatment. Most of the literature on polypharmacy consists of case reports, retrospective chart reviews, and open-label prospective studies, and describes the use of numerous combinations of medications, including lithium plus valproate, lithium plus carbamazepine, and valproate plus carbamazepine. Preliminary findings suggest these combinations may be effective, and that clozapine and high-dose levothyroxine may each be useful as well when combined with other drugs. Further research is necessary to formally evaluate whether these drug combinations are more effective than monotherapy. Until such studies are completed, certain general principles regarding side effects, pharmacodynamics, and pharmacokinetics should be kept in mind when prescribing two or more medications concurrently.     

Unusually large telomeric repeats in the yeast Candida albicans

We have identified sequences at the telomeres of the yeast Candida albicans and have found that they are composed of tandem copies of a 23-bp sequence. Through the cloning of native telomeric ends and the characterization and cloning of a "healed" end, we demonstrate that these repeated sequences are sufficient to function as a telomere. All copies of the 23-bp repeat that have been sequenced from a number of C. albicans strains are identical. In contrast, adjacent subtelomeric sequences are variable both between strains and within the WO-1 strain. In the WO-1 strain, the lengths of the telomeres are dependent upon growth temperature and are substantially longer at higher temperatures. Telomere growth is accompanied by increases in the number of the 23-bp repeats present on the telomeric fragments. These results suggest that either telomerase-maintained telomeres can be more complex in structure than was previously imagined or that Candida telomeres are maintained via a telomerase-independent mechanism.     

Inhibition of 2,3-oxidosqualene-lanosterol cyclase in Candida albicans by pyridinium ion-based inhibitors

The N-(4E,8E)-5,9,13-trimethyl-4,8,12-tetradecatrien-1- ylpyridinium and N-(4E,8E)-5,9,13-trimethyl-4,8,12-tetradecatrien-1- ylpicolinium cations were evaluated for their ability to inhibit 2,3-oxidosqualene-lanosterol cyclase activity in Candida albicans. Both compounds inhibited fungal growth, were fungicidal, and resulted in the accumulation of squalene epoxide concurrent with a decrease in ergosterol, monomethyl sterols, and lanosterol, as was expected for the specific inhibition of 2,3-oxidosqualene-lanosterol cyclase activity. These compounds are electron-poor aromatic mimics of a monocyclized transition state or high-energy intermediate formed from oxidosqualene, which may explain their selective action.     

Utility of Albicans ID plate for rapid identification of Candida albicans in clinical samples. Rapid identification of Candida albicans

A clinical study was carried out in an attempt to assess the efficacy of a newly designed electric toothbrush compared to a conventional manual toothbrush using the American Dental Association's protocol for evaluating toothbrushes. An Oral-B 35 manual toothbrush, which served as the control, was compared to the Plaq & White125 electric toothbrush. Examinations were performed by two calibrated examiners at baseline, day 15 and day 30. Examinations included the gingival index, plaque index and bleeding index. Mean indices were calculated and compared between the two brushes using the repeated measures multiple analysis of variance. No statistically significant differences between the mean indices on the three examination days were observed following the use of the manual or the electric toothbrushes. The results of this study demonstrate that the electric toothbrush was numerically more effective than the manual toothbrush in reducing supragingival plaque levels, either before or after brushing, at each examination date compared to baseline plaque values. However, this difference was not statistically significant. This and other findings concluded that the Plaq & White toothbrush is comparable to the control ADA-accepted toothbrush.